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This quality improvement study evaluates a PTA medical therapy algorithm combined with close telehealth follow-up at a tertiary center, targeting otherwise healthy adults with new-onset PTA, mild to moderate symptoms, and abscess size ≤2.0 cm on CT. Forty-eight patients were managed, with 89.6% success using medical therapy alone and no major PTA-related complications.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/medical-therapy-algorithm-with-telehealth-reduces-procedures-and-transfers-for-peritonsillar-abscess/446146/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/medical-therapy-algorithm-with-telehealth-reduces-procedures-and-transfers-for-peritonsillar-abscess/446146.png","ImageObject",300,407,{"name":92,"@type":93},"Quinn Holloway","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-08","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What patient group was eligible for the telehealth-supported medical therapy algorithm?","Question",{"text":112,"@type":113},"Otherwise healthy adults with new-onset peritonsillar abscess, mild to moderate symptoms, and abscess size ≤2.0 cm on CT imaging were eligible.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was telehealth follow-up incorporated into the treatment pathway?",{"text":117,"@type":113},"Discharged patients received scheduled phone or video telehealth follow-up with an otolaryngology advanced practice provider, ideally within 48 hours, plus standardized return precautions and contact information.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main outcomes after implementing the algorithm?",{"text":121,"@type":113},"Among 48 managed patients, medical therapy alone was successful for 89.6%, and no major PTA-related complications occurred; treatment failures were managed with salvage procedures or transfers when needed.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},446146,1791559996,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52,"preview_page_count":4},2336474466712,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","The Laryngoscope   \n RAPID COMMUNICATION  OPEN ACCESS   \nMedical Therapy Algorithm With Telehealth Reduces Procedures and Transfers for Peritonsillar Abscess  \nAviv Spillinger1  | Erin Dimon1 | Anna Schmidt1 | Joshua Gauger2 | Hani I. Kuttab2 | David O. Francis1  | Sandra Y. Lin1  \n1Department of Otolaryngology-Head & Neck Surgery, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin,  \nUSA | 2BerbeeWalsh Department of Emergency Medicine, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, USA Correspondence: Aviv Spillinger ([spillinger@wisc.edu](spillinger@wisc.edu))  \nReceived: 6 May 2025 | Revised: 30 August 2025 | Accepted: 8 September 2025  \nFunding: The authors received no specific funding for this work.  \nKeywords: peritonsillar abscess | telemedicine | unnecessary procedures  \n1 | Introduction  \nPeritonsillar abscess (PTA) is the most common deep neck space infection with ~45,000 annual cases in the United States and treatment costs exceeding $150 million USD [1] . Standard management typically involves surgical drainage by needle aspiration or incision and drainage [2] . However, emerging evidence suggests that many uncomplicated PTAs can be managed successfully with medical therapy alone [1, 3–9] . Several centers have adopted primary medical treatment algorithms, demonstrating reduced costs and minimizing overtreatment [1, 3] . This report presents preliminary findings from a quality improvement project evaluating whether a medical therapy algorithm, combined with close telehealth follow-up, can safely reduce unnecessary procedures and inter-hospital transfers for patients with small, uncomplicated PTAs.  \n2 | Methods  \nThis study was designated a quality improvement project by the Institutional Review Board (ID: 2023-0874) . A PTA medical therapy algorithm was developed by a multidisciplinary workgroup of emergency medicine physicians, otolaryngologists, and pharmacists based on evidence from prior publications [1, 4, 10] and implemented at a tertiary academic referral center beginning February 2024. Eligible patients presenting to an affiliated  \nemergency department (ED) or requesting transfer from nonaffiliated hospitals were managed according to this algorithm. At affiliated hospitals, the algorithm was embedded in the electronic record, allowing ED providers to initiate medical management without otolaryngology consultation. All transfer requests from non-affiliated hospitals or from affiliated hospitals without otolaryngology services were reviewed by the on-call attending otolaryngologists at the tertiary center for potential enrollment.  \nThe algorithm (Figure 1) applied to otherwise healthy adults with new-onset (i.e., not previously treated) PTA presenting with mild to moderate symptoms and abscess size ≤2.0 cm on computed tomography (CT) imaging. A 2 cm cutoff was selected based on prior literature [5, 7] and was agreed upon by the multidisciplinary workgroup as a pragmatic balance between patient safety—by restricting eligibility to lower risk, smaller abscesses—and provider acceptance, by choosing a threshold comfortable for clinicians accustomed to managing nearly all PTAs surgically.  \nDischarged patients were scheduled for a phone or video telehealth follow-up appointment with an otolaryngology Advanced Practice Provider at the tertiary referral center, ideally within 48 h. Patients also received standardized discharge instructions outlining return precautions and clinic contact information. Outcomes were assessed through follow-up documentation or, if unavailable, by chart review. Treatment failure was defined as  \n\n| This research was presented as a podium presentation at the Annual Meeting at COSM, The Triological Society, May 2025, New Orleans, LA, USA. Level of Evidence: 4, prospective case series without a control group. |\n| --- |\n| This is an open access article under the terms of the Creative Commons Attribution License, which permits us","cbCaikCIZ9Nze9sx","https://ap.wps.com/l/cbCaikCIZ9Nze9sx","pdf",617765,"English","# Introduction\n# Methods\n# Results","[{\"question\":\"What patient group was eligible for the telehealth-supported medical therapy algorithm?\",\"answer\":\"Otherwise healthy adults with new-onset peritonsillar abscess, mild to moderate symptoms, and abscess size ≤2.0 cm on CT imaging were eligible.\"},{\"question\":\"How was telehealth follow-up incorporated into the treatment pathway?\",\"answer\":\"Discharged patients received scheduled phone or video telehealth follow-up with an otolaryngology advanced practice provider, ideally within 48 hours, plus standardized return precautions and contact information.\"},{\"question\":\"What were the main outcomes after implementing the algorithm?\",\"answer\":\"Among 48 managed patients, medical therapy alone was successful for 89.6%, and no major PTA-related complications occurred; treatment failures were managed with salvage procedures or transfers when needed.\"}]","Medical Therapy Algorithm With Telehealth Reduces Procedures and Transfers for Peritonsillar Abscess | PDF",1790714295]